Should rash come alone in primary HIV?

Not necessarily. Primary HIV, also known as acute HIV infection or seroconversion illness, can manifest with a variety of symptoms and signs, and rash is just one of the possible presentations. The rash associated with primary HIV is often described as maculopapular, meaning it consists of flat, reddish-brown spots (macules) and slightly raised, solid lesions (papules). It typically appears on the trunk, face, and limbs, but can also involve the palms and soles. However, it's important to note that not all individuals with primary HIV develop a rash, and the absence of a rash does not rule out the possibility of primary HIV infection. A comprehensive evaluation, including a detailed medical history, physical examination, and laboratory testing, is necessary for an accurate diagnosis.